Survey findings from an ongoing research project in New Zealand have revealed a number of startling statistics regarding the effects of sleep deprivation on nurses.
Safer Nursing 24-7 is a 3-year project that combines new science along with nursing knowledge and experience to better understand and improve the fatigue management processes in New Zealand.
An integral part of this project has been the surveying close to 2000 nurses that have been utilised to create a better understanding of the cause of sleep deprivation and the consequences involved with being sleep deprived in a hospital-based setting.
While the full survey findings are yet to be released, there are a number of research findings housed within the projects draft code of practice that identifies the dangerous impact that a lack of sleep can have on both the nurses and those in their care.
According to the survey, 32 percent of nurses reported that they had actually fallen asleep driving home since becoming a nurse and 65 percent reported feeling close to falling asleep in the 12 months before undertaking the survey.
The vast majority of nurses reported getting less than 7 hours of sleep per night and more than 70 percent reported never or rarely ever waking up feeling refreshed.
The Side Effects of Shift Work
It is universally understood that human beings are physiologically wired to sleep during the night-time hours, but unfortunately, due to the 24-7 nature of hospital-based nursing environments like aged care settings, someone is always required to be rostered on.
Shift workers and those that work outside of the natural day/night cycle, do so at the detriment of their own physical and mental health due to the framework of their internal body clock.
A person’s internal body clock otherwise known as ‘circadian rhythm,’ regulates the body’s levels of alertness and tiredness throughout the 24 hour day cycle.
The negative effects of living outside the body’s internally regulated time-frame can wreak havoc on the wellbeing of those who work afternoon and night shift, and a lack of sleep hinders the human body’s ability to heal and stave off disease.
Night shift workers have a higher risk of disease when compared to those who work during the day and have a higher risk of developing heart disease, depression, obesity, insomnia and long term female night shift workers actually have a 19% increased risk of developing cancer.
This negative effect on wellbeing is also making it increasingly difficult to retain nurses who are willing to work outside of day time hours.
There are a number of physical and mental symptoms that arise from lack of sleep that can have a direct impact on the way a nurse is able to provide care.
These can include slower reaction times, poor coordination, forgetfulness, slow processing of information and a lessened ability to pay attention.
These symptoms can degrade patient care by increasing the risk of a number of negative workplace outcomes including clinical error, workplace injury and drowsy driving accidents.
What Is the Next Step?
A big part of the Safer Nursing 24-7 project is the National Code of Practice For Managing Fatigue and Shift Work in Hospital-Based Nursing.
This code, currently at draft stage, is being led by Professor Philippa Gander alongside NZNO and looks to utilize data from within the surveying portion of the project to create a code of conduct to help identify, mitigate and manage nurse fatigue.
Due to the 24-7 environment of hospitals and aged care environments fatigue and the negative effects of shift work are virtually impossible to avoid.
Speaking to the New Zealand Nursing Review, Professor Gander and Sleep/Wake researcher Dr. Karyn O’Keefe conceded that fatigue is inevitable but with a change of culture and the new draft code – district health boards could develop a shift-work management system that reduces the risk of fatigue being a safety hazard.
The code does not recommend restrictions on nurse work patterns (eg. maximum shift lengths, number of consecutive shifts etc) but provides a fatigue hazard assessment matrix that can be used to assess and preempt nurse fatigue.
The matrix (table of reference) evaluates weekly work patterns and takes into account six work pattern variables and two sleep pattern variables to assess a nurses fatigue levels.
Gander and O’Keefe both hope that once they had received feedback and finalised the Code of Practice they hoped to pilot the code in a major public hospital.